How are the youngest among us faring as COVID-19 becomes endemic?
Few adults have emerged from the COVID-19 pandemic unscathed. The far-reaching and ever-resurfacing virus has tested our resolve and political beliefs; it has stressed relationships and health care systems; it has jeopardized our health and livelihoods.
Unfortunately, our kids have not been spared. They have experienced their own pandemic-related stress. Adolescents in particular feel anxious about disruptions in the normal routine and structure of the school day. They feel disconnected from friends and worry that they have fallen behind academically.
And when their families have experienced a lot of pandemic-induced stressors—not being able to meet basic needs, unreliable childcare, financial pressures—kids are likely to feel the pain, especially during periods of lockdown.
Professionals say that mental health challenges in kids have been rising over the past 10 years, so this is nothing new. But incidents have jumped significantly since COVID-19 became a household word.
In fact, the American Academy of Pediatrics, Children’s Hospital Association, and American Academy of Child and Adolescent Psychiatry are so concerned about the soaring rates of mental health issues among children and adolescents that they jointly declared a national state of emergency in children’s mental health in October 2021.
So, what’s going on with the kids? We checked in with alumni and faculty experts from psychology, education and social work to get a snapshot of the challenges facing children and teens and the impact on their mental health.
Rising rates of mental health conditions
Alumna Kiara Kuenzler (PsyD ’08) has her finger on the pulse of the mental health community.
“It’s been challenging to see the growing mental health need over the course of the pandemic,” says Kuenzler, president and CEO of the Jefferson Center, a Front Range-based nonprofit organization that provides mental health care and substance-use services. “Mental health has been impacted by the pandemic, and we’re seeing the highest increase in mental health symptoms among adolescents and young adults.”
The rate of mental health challenges for adolescents doubled from 2017 to 2021, according to Kuenzler. Challenges include depression, anxiety, stress and suicidal ideation.
“Depression by and large seems to be the largest cluster of symptoms that kids are experiencing. The rate of depressive symptoms is pretty staggering,” she adds.
Signs of depression vary by the age of the child. Whereas adults talk about feeling sad and lonely, children tend to be more withdrawn, more irritable or act out. Often, they don’t want to engage in normal activities. According to recent studies, almost 40% of children and youth experienced some symptoms of depression in the past year.
“The good news is that we’ve also seen an increase in the number of people reaching out for help,” Kuenzler says. Data on Colorado kids indicates that 33% of children and teens reported that they had talked to someone about their mental health, up from 22% in 2017.
The rise in mental health challenges tracks with what Jena Doom sees in her work as an assistant professor of developmental psychology in DU’s Department of Psychology.
“Teens are telling us that they’re struggling with mental health. They’re experiencing a lot of challenges, and that’s reflected in the national data,” Doom says. “We see increased rates of suicide-related behaviors and attempts, which are reflected in increased emergency room visits.”
Not all kids have experienced the pandemic equally. While some have weathered the storm with a supportive family, rewarding social connections, significant financial resources, and a safe and secure living and learning environment, others faced significant challenges.
“Teens who identify as transgender, nonbinary, gay, lesbian or bisexual have really high rates of mental health problems, especially during the pandemic,” Doom says.
Girls are typically more at risk than boys for mental health problems like depression and anxiety. Kids who experience racism and those who are not able to access mental health care have higher rates of mental health problems, she adds.
In addition, a number of concerns have only worsened in the last couple of years:
- Increasingly, at least one parent has lost a job, creating housing and food insecurity.
- The pandemic has led to higher rates of emotional and physical abuse at home.
- Kids have lost connections with friends and teachers.
- According to the National Institutes of Health, more than 140,000 children in the United States lost a primary or secondary caregiver to COVID-19 in the first 15 months of the pandemic.
While mental health is on everyone’s radar, physical health is also affected when children experience a pandemic over multiple years or there are other stressors, such as emotional or physical abuse, at home. An initial short-term problem can lead to a long-term problem if stress is chronic, Doom explains.
“In the short term, greater stress is associated with immune system suppression, so you may be more likely to get COVID-19. You may also be having problems like stomach aches, headaches, or a racing heart. When stress becomes chronic, it is associated with long-term problems, including inflammatory diseases like lupus, arthritis or cardiovascular disease,” she says.
Inequities in education
COVID-19 caused the biggest disruption in the history of American education, with schools closing and opting for Zoom classrooms. Although some students thrived in a remote learning environment, many did not.
According to a recent report by the Department of Education, there were disparate impacts of COVID-19 on America’s students. Educational gaps in access, opportunities, achievement and outcomes widened and disproportionately impacted students who went into the pandemic with the greatest needs and the fewest opportunities—many from historically marginalized and underserved groups.
This comes as no surprise to Kamilah Legette, an assistant professor in the Department of Psychology and director of the Reducing Inequities in Student Education (R.I.S.E) lab. She says that, given systemic racism, many children experiencing structural barriers to remote learning are from racially minoritized backgrounds.
According to Legette, many underprivileged students are not afforded the resources necessary for online learning, such as access to a computer or to Wi-Fi, both considered a privilege. Even if access is available, many families with multiple children don’t have multiple computers for individual use. Because of these challenges, children might not have their cameras turned on, or might not attend remote class.
“Teachers’ perceptions of children who attend remote class and have their camera on can exacerbate inequities during the pandemic,” Legette says.
“Prior to the pandemic, research indicates that teachers hold lower academic and behavioral expectations for
Black and Latinx children, perceiving they do not care about school or learning and that they have parents who are not involved in their education,” she says. “These perceptions are exacerbated with the pandemic shaping how teachers might respond to Black and Latinx children who do not have their cameras on or attend remote class.”
The R.I.S.E. lab investigates social-emotional learning (SEL) practices that can be implemented with a racially inclusive focus. SEL is the process of developing self-awareness, self-control and interpersonal skills.
“Social-emotional learning and the competencies deemed appropriate were developed based on white middle-class children’s development,” Legette says. “As such, prominent SEL practices and interventions do not account for the racism that Black children encounter. Using SEL practices that have a specific attention to racism will promote positive social-emotional development for racially minoritized youth.”
Alfredo Pargas (EdD ’22) and his wife, Molly (EdD ’22), have had their own experiences with education inequities. Both DU alumni taught English language learners at Keller Elementary in Colorado Springs during the pandemic. When schools closed and moved to online learning, many of their students were locked out of the virtual classroom because they lacked computer or Wi-Fi access, a common predicament for ELL students.
That’s when Alfredo Pargas jumped into action, providing each of his students and their families the tools and support they needed to successfully learn online. One by one, students started to show up in class.
“While remote learning was not ideal for language acquisition, and for primary grades, it was a benefit as it exposed our ELL students and families to technology on a new level,” Pargas says. “A lot of our ELL families had never had internet or computer access at home. We went from students not having that access to it being the norm as well as a priority for families.”
Pargas sees inequities in the education system that make learning more difficult for his students and says computer literacy and access to technology are important steps toward closing the digital divide.
“There is a lot of discrimination that is faced by ELL students and their families,” he says. “It begins with their lack of English proficiency and then moves on from there.”
Making matters even more problematic, many schools lack culturally and linguistically diverse leaders to serve the needs of the fastest growing populations. “Preserving the status quo, ‘the way things have always been done,’ is one of the biggest disservices to our Latinx and ELL populations,” he says.
Schools on the front lines
The grief, anxiety and depression children have experienced during the pandemic is welling over into classrooms and school hallways. Erin Anderson, associate professor of educational leadership and policy studies at the Morgridge College of Education, says educators are seeing more outbursts from struggling students and sometimes aggressive or violent behavior, from the youngest all the way up to high school.
“I think that is related to increased frustration because they haven’t been dealing with as many people over the last couple of years, and they haven’t been developing those relational skills that are necessary for being in group settings and handling frustration and self-regulation,” Anderson says.
According to a May 2022 National Center for Education Statistics report, 70% of public schools reported an increase in the percentage of their students seeking mental health services at school since the start of the pandemic. In addition, 76% of schools reported an increase in staff voicing concerns about their students exhibiting symptoms such as depression, anxiety and trauma.
Because many schools lack mental health resources, teachers often are the first line of defense, which is adding more stress to an already stressful job.
“The number of teachers that are reporting that they’re burning out and that they’re just too stressed to continue teaching is up,” Anderson says. “Most of the educators that I talk to on a regular basis had more teachers leaving in the middle of the year this year than ever before.”
Anderson says that teachers are being asked to, and need to, implement more social-emotional learning. “Some groups feel like schools are for academics only and social-emotional learning doesn’t belong there. I think we’re at a point where we’re really recognizing that they are interconnected.”
Although teachers typically have taken one or two professional-development classes around mental health, they are not trained mental health professionals, Anderson says. And that’s what schools need right now.
Julianne Mitchell, a licensed clinical social worker (LCSW) and a clinical associate professor in the Graduate School of Social Work, has worked with children and youth for over 20 years. She notes that depression and anxiety were already on the rise pre-pandemic. Parents, caregivers and teachers have struggled to address challenging behaviors at home and school. Access to mental health services has always been a challenge, particularly for oppressed and marginalized populations. Academics have traditionally been prioritized over social and emotional learning. The pandemic, not surprisingly, exacerbated these alarming problems to an unprecedented level.
“When we stress, we regress,” Mitchell says, describing the potential impact of chronic stress on our brains and nervous systems. “We’re seeing a lot of dysregulation and challenging behaviors, such as screaming, hitting and tantrums. It is important to look beyond the behaviors and be more curious about the underlying causes for the behavior. It’s a stress response. Children communicate their inner world through behaviors.”
When schools closed at the start of the pandemic, many kids missed out on critical services, including nutrition and health care. Many marginalized families or those experiencing poverty felt the safety net disintegrate.
“What is the impact of poverty on development and the ability to learn? How do you go into school if you’re hungry? What are the expectations around learning if your tummy’s growling, if you don’t feel safe?” Mitchell asks.
“Kids can’t fully heal if they’re not feeling safe, and it’s a general sense of safety that we’ve lost,” she says, adding that the world has become increasingly more violent including war, school shootings and violence toward our BIPOC (Black, Indigenous, People of Color) and LGBTQ communities.
With that in mind, many schools have begun to respond. Mitchell has seen a push toward increasing mental health support services in school settings—a step in the right direction. Mitchell also has seen an increase in telehealth services, which remove barriers for many families.
As a play therapist, Mitchell would like to see children and youth have more access to unstructured play and play therapy services. Play is important to regulate the nervous system and help kids learn new skills. “Some of the challenges that we’re seeing with kids relates to a lack of coping skills, problem solving and conflict resolution. We need to carve out time for kids to play with each other.”
While school-aged kids are showing signs of pandemic-related stress, it’s not so apparent in their youngest
counterparts, according to John Holmberg, a research associate professor in DU’s Graduate School of Professional
Psychology. He and his team in the Caring for You and Baby (CUB) Clinic support the mental health and developmental needs of pregnant and postpartum families with infants and young children.
So far, the CUB team has not seen unusual developmental delays and challenging behaviors in children under 5. However, symptoms may present over time as children are being observed and referred for screening.
“Most developmental phenomena have multiple contributing causes,” Holmberg says. Although some data indicate that children experienced increased rates of significant stressors during the pandemic, it may be difficult to pinpoint if the pandemic caused negative developmental outcomes.
If there were such outcomes for young children, is it possible to turn the situation around?
“The great thing about child development is it represents a big window to intervene, to enhance adaptability, and it represents opportunities for significant growth, given the right types of help and resources,” he says.
“If folks are concerned about pandemic-related impacts on their child’s or children’s development or mental health, I’d encourage them to reach out to their professional allies—pediatricians, teachers and intervention specialists at school, as well as community-based mental health professionals,” Holmberg says.
As it happens, many people appear to be seeking help and support for their kids, whether they are teens contending with hopelessness or youngsters starved of valuable social interactions. And with more people seeking help,
the stigma around doing so appears to be receding, bit by bit.
Perhaps, once all is said and done, that will be the pandemic’s silver lining.